摘要:

AbstractRound Window Membrane Rupture is a surgically correctable cause of sudden hearing loss and vertigo. Reported is a 19‐year‐old male who had proven round window membrane rupture secondary to barotrauma. Surgical exploration revealed an abnormally large round window niche and membrane, possibly predisposing him to this injury. Diagnostic and therapeutic modalities of this entity are presen

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00001

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractClinical and experimental evidence has revealed that rupture of the round window membrane, by itself, is not a major cause of sensorineural hearing loss. Eighteen guinea pigs underwent removal of the round window. The status of cochlear function was determined by recording the cochlear microphonic. An average loss of only about 6 db was observed after surgery.It is felt that there must commonly be more cochlear damage concurrent with window rupture to explain the significant and often relatively immediate hearing losses seen in clinical practice. The site(s) of this primary trauma has not yet been discovered, but it would seem reasonable in the light of recent reports that the perilymphatic vessels, the vas spirale, the stria vascularis and/or the integrity of the cochlear duct might be involved in the genesis of this hearing loss.We propose that the term “round window rupture syndrome” be used as a more accurate description of this entity. The round window damage provides evidence of more devastating trauma within the cochlea. Thus, the clinician, being alerted, should not stop his therapeutic efforts with surgical closure of the RW. Better prognosis for the patient, as well as leading into new avenues for the investigation of cochlear function, would be the res

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00002

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractSuppurative middle ear effusions (MEE) have been shown to occur commonly in neonates. In spite of this, otoscopy is not routinely performed on septic infants in the neonatal intensive care unit (ICU). This is clinically significant since unrecognized suppurative MEE may act as a focus for dissemination of bacteria into the circulation and/or central nervous system (CNS).We have completed a prospective study in an attempt to define the prevalence, bacteriology, and response to therapy of MEE in neonates. To facilitate this, the normal micro‐otoscopic appearance of the newborn TM was established by systematically examining 50 normal infants under 24 hours old.MEE was present in 30% of 125 consecutively examined infants in the neonatal ICU. Bacteriologic data are drawn from tympanocentesis performed on 34 neonates. Nasotracheal intubation of longer than seven days is highly associated with suppurative MEE. Suppurative MEE in the neonatal ICU is often refactory to treatment and may require prolonged therapy and repeated tympanocentesi

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00003

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractTinnitus has long been a problem which has plagued patients with otologic problems. We have been using biofeedback as a method of treatment for patients with severe debilitating type tinnitus. Most of the patients had sensori‐neural type hearing impairment while a few had conductive hearing loss and normal hearing. The patients were given 10&12 one hour sessions of biofeedback training. They have been followed from 6 to 12 months after this initial training period. Over half of the patients participating in the study report an improvement in their condition. A few of the patients were dramatically improved while none are worse. Biofeedback has been shown to be an excellent method of treatment for patients with severe tinnitu

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00004

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractTinnitus Clinic was established at the University of Oregon Medical School and the result of treatment for 158 patients is discussed. Patients received three forms of masking as treatment: masking from hearing aids, masking from the Tinnitus Masker, and FM‐Masking. Conditions leading to each kind of recommendation are discussed. The examination procedures used in the Tinnitus Clinic are presented. The phenomenon of residual inhibition is explained and discussed in relation to possible long‐term or permanent relief of tinnitus.Future plans for the clinic and needs of tinnitus patients are presen

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00005

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractCongenital malformation of the ear has a complex origin and the possibility of hereditary, viral and toxic etiologies.The authors require audiometric evaluation, using the objective brain stem evoked response in young children, and polytomography of the middle and inner ears in all patients with atretic external auditory canals.Unilaterally atretic ear canals can be repaired electively at the discretion of the family and the patient, while in bilateral cases reconstruction is ideally done at approximately age four years. Regular follow‐up is recommended to be certain that no cholesteatoma develops medial to an atretic external ear canal. The authors propose a working classification for congenital malformation of the ear.In the authors' series of 35 operations for the repair of congenital ear abnormalities, 55% were improved to adequate levels of hearing without the use of a hearing aid. Eight exemplary cases and comments are presente

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00006

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe epidemiology of head and neck cancer can be accounted for largely in terms of known carcinogens introduced into the body through the mouth. Though there are many environmental exposures—such as asbestos, radon, nickel and arsenic—which have strong carcinogenic effects, most of these have only a small impact on the general population because exposure is limited, usually to small occupational groups. Two prevalent exposures, however, tobacco and alcohol, are strong risk factors for nearly all sites in the head and neck, and together account for about 80%&90% of all cancers of the head and neck. There is evidence for biologic interaction between some occupational exposures and cigarette smoking for cancer of the lung, and tobacco and alcohol for cancer of the mouth. Based on this evidence for biologic interaction and the prevalence of smoking, it seems likely that tobacco is related to about 80% of all cancers of the head and neck in the United Sta

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00007

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe traditional radical neck dissection involves excision of the spinal accessory nerveen blocwith the soft tissue of the posterior triangle in an effort to remove completely all node‐bearing tissue. The resultant decrease in range of motion of the involved extremity and subsequent pain have prompted some surgeons to seek alternatives. The purpose of this study is to review prospectively radical neck specimens with the specific intent of evaluating the frequency of metastatic involvement of the spinal accessory lymph nodes with head and neck malignancies. Fifty neck specimens were studied and the frequency of cancerous involvement of the spinal accessory nodes was not found to be significantly different from nodal involvement of the entire neck specimen. The location of accessory nerve involvement was predominantly in the proximal portion which is not within the posterior triangle. The results are further evaluated with the subsequent conclusion that preservation of the spinal accessory nerve cannot be justified on the basis of infrequent involvement with metastatic lymph node

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00008

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe development of computerized tomography (CT) has been called the most important contribution to medical diagnostic techniques since Roentgen discovered the X‐ray in 1895. Over the past several years, the growth in technology and literature concerning computerized tomography has been rapid. CT is useful in evaluation of head and neck lesions such as lesions of the paranasal sinuses, the nasopharynx, base of skull, the larynx and neck areas. It is also useful in evaluation of intracranial complications of head and neck diseases. CT has added the horizontal plane in the evaluation of these lesions. The ease of obtaining CT scans and its non‐invasiveness are advantages. The most important single feature of CT that distinguishes it from other radiographic techniques is the capability of imaging of soft tissue. CT demonstration of bone destruction is not superior to polytomography. The transaxial orientation of CT planes seems to be particularly useful in certain locations such as the pterygopalatine fossa. CT is an additional diagnostic tool, but it has limitations of other radiologic techniques in differentiating histologic types. In this series, one case of ethmoiditis resembled carcinoma. In another, radiation necrosis was indistinguishable from intracranial metastasis. As technology advances in the use of CT, its application in head and neck lesions will be increas

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00009

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThis study compares the published clinical and pathological features of hemangiopericytoma‐like intranasal tumors with those of the hemangiopericytomas of other sites.Hemangiopericytoma‐like intranasal tumors often originate in a paranasal sinus and extend into the nasal cavity secondarily. They occur most commonly in adults in the sixth and seventh decades of life and clinically mimic allergic polyps. These patients most commonly present with symptoms of nasal obstruction and epistaxis. Microscopically, these tumors demonstrate a vascular architecture, are composed predominantly of spindle cells, and lack nuclear or cytoplasmic pleomorphism, mitotic activity, hemorrhage, or necrosis. Follow‐up data suggest that these tumors are unaggressive and are of local consequence only.Hemangiopericytomas of soft tissues usually occur in the retroperitoneum or the thigh and are uncommon in the nasal and paranasal sinuses. They usually present as painless masses. Attention to certain microscopic features of these tumors has led to reasonably good predictions of their behavior based on strict adherence to microscopic criteria. These criteria include the presence or absence of mitotic figures, necrosis, anaplasia, and hemor

ISSN:0023-852X    

DOI:10.1288/00005537-197803000-00010

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY